Provider Demographics
NPI:1699873158
Name:WRC HEALTH CARE SUPPORT SERVICES
Entity type:Organization
Organization Name:WRC HEALTH CARE SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWONGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-849-5913
Mailing Address - Street 1:985 ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-7213
Mailing Address - Country:US
Mailing Address - Phone:814-849-1205
Mailing Address - Fax:814-849-7426
Practice Address - Street 1:18 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-1540
Practice Address - Country:US
Practice Address - Phone:814-849-5913
Practice Address - Fax:814-849-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA02240501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017123900002Medicaid
PA398054Medicare Oscar/Certification